gestational diabetes ost RNY (long and need input from scientifically minded!)

Ok... for those of you who have managed to take the oral GTT.  How were your results?  I had mind this morning ( I only dump a little most of the time, tolerated it fairly well)  Anyway, fasting BS was 80... super! post 75grams Glucose (which I never consume)  227!!!!  Yikes... not a good number.  An hour later it was 79! 

I've done a quick research review and cannot find any definitive explanation for this.  The recommendations on how to screen for diabetes post RNY are ACROSS THE BOARD!!

According to american standards... this is a negative test... hooray.  BUT, according to European standards (which is where I am)  this is positive finding for gestational diabetes!  My theory is that because of the hyperosmolality... the glucose which I drank probably was absorbed much more rapidly (just like when we drink wine, we feel like we've had 3 glasses rather than 1)... sugar peaks then drops rapidly...

My doctor isn't sure how she should interpret this (has never had post RNY pregnant patient)....  no one in this area has.

I think it's negative (based on american standards, it is!)  What do you ladies think?  Maybe just to be on the safe side should do a few random and post prandial checks...  I talk with her again on Thursday.....

 I had my test recently too... don't know my specific numbers, but I "passed".
I have a DS though, we don't really 'dump' like RNY.
I've heard some RNY mamas on this board talk about declining the glucose tolerance test all together b/c the dumping can render it inaccurate. Hopefully, someone more knowledgable will chime in soon!

I was under the impression that these tests don't work for us (don't give accurate results), even if we don't have dumping issues.

I had RNY like you and my RE, Ob/GYN, and Perinatologist all consulted and did not feel they could get an accurate result on the test even though I thought about taking it since I do not have too many issues with dumping. They felt because of how our bodies absorb, or rather malabsorb, it would not give true results and they did not want to take chances. Instead I was given a glucose monitor and did 4 tests a day: before breakfast, after, and then after lunch and dinner. The monitor stored the results and provided a read out to them after I went back in two weeks. This seemed to be a better approach for me.

I think these tests are a bunch of BS anyway unless you normally consume 75g of sugar at a time. With no other fat or protein. And then just sit still for a few hours afterwards. Who does that?!

What you've described is essentially the mechanism for reactive hypoglycemia, just that you didn't go low enough to be considered hypo. Due to the bypassed pylorus, sugar hits the intestine and is absorbed faster than usual, causing an initial spike. Then a rush of insulin is released to battle that spike, which makes the level come crashing back down quickly.

I didn't have an RNY, but I'm declining the GTT anyway. I have a glucometer and test my glucose levels at home myself. My OB said to be on the lookout for fasting levels of 95+ or 2-hour post-prandial levels of 125+. So far, my fastings are consistently in the 70s, and no high post-prandials to report, either.

I will say that, based on your results, I would be careful with carb consumption because you may be headed for reactive hypoglycemia. But, as you said you never consume sugar like that (though it can also be other carbs like potatoes, pasta, rice, sugary fruits, etc.), it's probably not a concern. I wouldn't say it is indicative of gestational diabetes. The "pass/fail" criteria are written based on normal, non-internally-adjusted patients.

From what I understand as long as your sugar goes back down to a normal # by 2 hours you are fine it shows your body it producing enough insulin and storing sugar the right way.